SERPINA1 and hyperinsulinemic hypoglycemia, familial, 4: Looking at the different alleles for the of the alpha-1 antitrypsin (SERPINA1) gene, a study undertaken by Dahl et al. concluded that alpha-1-antitrypsin deficiency in ZZ and MZ genotypes is associated with reduced blood pressure in individuals with ischemic heart disease (IHD) as compared to MM/MS genotypes.